Painful trigeminal neuropathy is a potentially debilitating yet not well known neurological disease. Its hallmarks are specific sensory abnormalities and persistent facial pain. This review consolidates current knowledge on its symptoms, underlying causes, diagnostic challenges including the differential diagnosis, and treatment options linked to this condition. The pathognomonic symptoms of painful trigeminal neuropathy help in correctly diagnosing this condition. These include sensory disturbances of painful trigeminal neuropathy, such as hypoesthesia, hyperesthesia, itching symptoms, taste alterations as well as motor function disturbance of the jaw. Depending on which specific branches of the trigeminal nerve are involved in each patient, the symptoms can differ accordingly. Therefore, understanding of the distribution and nature of the symptoms of painful trigeminal neuropathy is crucial for diagnosis. The pathophysiology is influenced by a broad range of etiological events, including infections, trauma, systemic illnesses, and surgical procedures. To distinguish painful trigeminal neuropathy from other illnesses causing facial pain, such as trigeminal neuralgia, a comprehensive clinical evaluation and imaging procedures, including magnetic resonance imaging, are necessary for the diagnosis process. Painful trigeminal neuropathy is treated individually with a range of approaches, from minimally invasive and medicinal therapy to more involved forms of care.